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13 Feb 2012

I have been contemplating for several days (hence the lack of any recent blogs) whether or not to post what I am about to do. Despite it being very personal, I finally decided that any privacy issues are outweighed by the benefits of sharing what I have learnt over the past several days.

For many years, going back to at least 1991, I have been plagued by chest pains… Angina. Around this time I would have been just about 21 years old, so that these pains started while I was quite young, and in the peak of my health. At this age, I had been hitting the gym for approximately 5 days per week, three hours per day, since I was around age 17. So when I say that I was fit as a fiddle, it is an understatement.

On Angina:

“Once the hardening and narrowing of your coronary arteries reaches a certain point, your heart no longer receives the blood supply it needs to work properly. This can trigger the symptoms of angina, including:

pain or discomfort in your chest

breathlessness

When the symptoms of angina start, it is sometimes called an angina attack.

There are two types of angina:

stable angina, where symptoms only last a few minutes, are triggered by physical activity and can be relieved with medication

unstable angina, where symptoms develop even when you are resting, last longer than five minutes and cannot usually be relieved with medication.”

Around this time I had been diagnosed with having high cholesterol problems, and with the medication costing approximately $2000 per month (more than my salary) I could not afford it. Following a period of numbness in my left arm and shoulder, I had my first series of cardiac assessments at Mt Hope (Eric Williams Medical Sciences Complex). Despite being given the all clear, for the next two decades I had been plagued with the same chest pains.

After arriving in England, I notified my general practitioner (GP) of my high cholesterol problem (Hypercholesterolemia), and I was put on a regimen of cholesterol-lowering drugs. Fortunately, in England medication is highly subsidised, and at the time that I came here, the cost to me was approximately £18 per month, (£6 per item per prescription). It took approximately 8 years of trial and error, mixing and matching dosages and combinations of drugs before my cholesterol dropped to a "safe" level.

Two years ago, I experienced a very… memorable… pain, while on the bus. By good fortune, the hospital was only 2 stops away, so I dropped off at the A&E dept.… professionalism at its best, oh First World Aspirants. Within 3 to 5 minutes I was on a bed, hooked up to an ECG machine and a nurse was taking history and vitals.

Anyway, the short of this story is that the ECG showed nothing unusual, but I was re-called for a treadmill test (Oh Gawd, efficiency, eh?), which I ‘failed’ – no signals detected in my legs by the probes. I was then re-called for an angiogram, which showed blockages (atherosclerosis) in my circumflex and left anterior descending arteries.

On Atherosclerosis:

Atherosclerosis is a potentially serious condition where the body’s medium and large arteries become clogged up by fatty substances, such as cholesterol. These substances are called plaques or atheromas.

Hardening and narrowing of the arteries is potentially dangerous for two reasons:

Restricted blood flow to an organ can damage it and stop it functioning properly.

If a plaque ruptures (bursts) it will cause a blood clot to develop at the site of the rupture. The blood clot can block the blood supply to an important organ, such as the heart, triggering a heart attack, or the brain, triggering a stroke.

Atherosclerosis is more common in men than in women. It is thought that this is because the sex hormones that are used in the female reproductive cycle, such as oestrogen, provide protection against the effects of atherosclerosis.

Risk factors that can dangerously accelerate the process of atherosclerosis include:

For reasons that are not fully understood, high blood pressure and atherosclerosis are more common among people of African-Caribbean and south Asian (Indian, Pakistani, Bangladeshi and Sri Lankan) origin.